Carbamazepine

Carbamazepine is used in medicine as an active ingredient for the prevention and treatment of neurological diseases. It is mainly used for the prophylaxis of seizures. The active ingredient is often prescribed in Germany.

What is carbamazepine?

Carbamazepine is a substance called an anticonvulsant. Anticonvulsants are medicines that are used to treat and prevent epileptic seizures. Chemically, it is assigned to the class of dibenzazepines. It is similar in structure to the substance imipramine.

Synonyms for carbamazepine are 5H-dibenz [b, f] azepine-5-carbamide, 5H-dibenzo [b, f] azepine-5-carboxamide and Carbamazepinum. The molecular formula of the substance is C15H12N2O. The carbamazepine is available as a white or almost white crystalline powder for processing. It is polymorphic, so it can appear in different forms. The physical state is fixed. Carbamazepine is very sparingly soluble in water. It is easily soluble in dichloromethane and slightly soluble in acetone and ethanol 96%.

Pharmacological effect

The substance carbamazepine works in the human body by blocking sodium channels that are located in the axons of nerve cells. The exact mechanism of action has not yet been conclusively clarified. The active ingredient is absorbed relatively slowly within 6 to 8 hours after ingestion. The bioavailability is 80%. The therapeutic range of carbamazepine is narrow. An exact dosage is therefore important, on the one hand to achieve the desired effect, but on the other hand to avoid overdosing. It is important to ensure the correct dose and strictly regular intake of the drug.

Carbamazepine is metabolized in the liver in the human body. The processing takes place via enzymes of the cytochrome P450 system. Carbamazepine induces the enzyme system. The substance is mainly metabolized in the enzyme CYP3A4. Since numerous drugs are metabolized via the cytochrome P450 enzyme system, there is a possible risk of interactions between carbamazepine and other drugs.

When carbamazepine is metabolized in the body, the secondary product is carbamazepine-10,11-epoxide. This substance is also anticonvulsant. However, he should also be responsible for side effects of the drug.

Medical application & use

In medicine, carbamazepine is used as a drug for the treatment of various neurological diseases. In Germany, you need a prescription. The active ingredient is used to treat and prevent various forms of epilepsy. It is used for partial seizures. These are seizures that start in a specific area of ​​the brain. Carbamazepine is used to treat both simple partial seizures (without unconsciousness) and complex partial seizures (with unconsciousness). Generalized epileptic seizures affect both sides of the brain. Carbamazepine is also used for these. The active ingredient is also used in mixed forms of epilepsy.

Another area of ​​application of the drug is trigeminal neuralgia. This is seizure-like facial pain that originates from the trigeminal nerve on the face. With glossopharyngeal neuralgia, patients experience pain in the throat. This disease can also be treated with carbamazepine.

Diabetic polyneuropathy is a secondary disease of diabetes and another area of ​​application for the active ingredient. Carbamazepine is also used for symptoms of multiple sclerosis such as abnormal sensation, pain, speech or movement disorders.

Another area of ​​application is the prevention of epileptic seizures in the context of alcohol withdrawal. In manic-depressive illnesses, the active ingredient is used to prevent phases of the illness.

Carbamazepine is in tablet form. Depending on the dose and dosage form, it can be used in adults and children.

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Risks & side effects

The use of carbamazepine often leads to dizziness, tiredness, drowsiness and movement disorders. Nausea, vomiting and loss of appetite can also occur frequently. Carbamazepine can cause hypersensitivity reactions with rash, fever and general symptoms. Serious allergic reactions including anaphylactic shock are very rare.Serious to life-threatening skin reactions have been reported in connection with the use of carbamazepine in isolated cases.

The intake of carbamazepine can lead to changes in the blood count, which are usually harmless. Difficult courses are very rarely possible. The active ingredient can cause water to be retained in the tissue. Laboratory parameters such as electrolytes, liver or thyroid values ​​can be changed. Effects of the substance on the cardiovascular system with cardiac arrhythmias and effects on blood pressure can occur.

The drug can interact with the simultaneous use of various other, especially neurologically effective, agents. The simultaneous consumption of grapefruit juice and carbamazepine can influence the plasma level of the active ingredient, i.e. the absorption of the active ingredient into the blood. The drug should never be taken together with alcohol.

This representation is not a complete description of all possible side effects and interactions.